Predicting long-term functional limitations among back pain patients in primary care settings

Clermont E. Dionne, Thomas D. Koepsell, Michael Von Korff, Richard A. Deyo, William E. Barlow, Harvey Checkoway

Research output: Contribution to journalArticlepeer-review

159 Scopus citations


To identify predictors of back-related long-term functional limitations, 1213 adult enrollees of a Health Maintenance Organization (HMO) in Washington state were interviewed about a month after a consultation for back pain in a primary care setting in 1989-1990, and followed each year thereafter. Out of 100 factors documented at the one-month assessment, measures of somatization, depression, functional limitations, and pain were the strongest predictors of two-year modified Roland-Morris score among a random subsample of 569 subjects. A multiple regression model containing the Symptom Checklist Depression and Somatization scores, the one-month modified Roland-Morris score and the number of pain days in the past six months explained about 30% of the variance in the outcome. Using recursive partitioning, a very simple model was developed to identify patients at high risk of sustaining long-term significant functional limitations. The regression model and the recursive partitioning model were successfully tested in a fresh sample of patients (n = 644). Clinical application of the recursive partitioning model and methodological aspects of this study are discussed.

Original languageEnglish (US)
Pages (from-to)31-43
Number of pages13
JournalJournal of Clinical Epidemiology
Issue number1
StatePublished - Jan 1997


  • Back pain
  • Functional limitations
  • Outcome prediction
  • Recursive partitioning

ASJC Scopus subject areas

  • Epidemiology


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